No description available.

Resumo: As enteroparasitoses comumente afetam o equilíbrio orgânico dos animais de estimação, sendo isto particularmente preocupante em relação aos cães, devido ao intimo contato destes com o homem. As técnicas coproparasitológicas usualmente utilizadas na rotina laboratorial para detecção de parasitoses gastrintestinais são indispensáveis para o diagnóstico e por conseqüência para determinar a necessidade de tratamento dos animais infectados. Neste estudo objetivou-se avaliar a ocorrência de helmintoses e protozooses em cães domiciliados e sua associação com faixa etária, sexo e raça, bem como a eficiência dos Métodos Willis- Mollay, Faust, Sedimentação e Exame Direto quanto a recuperação de ovos e oocistos de parasitos gastrintestinais da espécie canina. Foram processadas 401 amostras fecais, sendo que em 300 foi efetuada a Técnica de Kinyoun para pesquisa de Cryptosporidium spp. Os parasitos encontrados foram Ancylostoma spp. em 53,1%, Toxocara canis em 20,7%, Cystoisospora ohioensis em 15,7%, Trichuris vulpis em 3,7%, Dipylidium caninum em 2,5%, Cryptosporidium spp. em 1,33% e Taenia spp. em 1,0% das amostras. A positividade para Ancylostoma spp. não foi influenciada pelas variáveis raça, sexo e idade. Houve diferença estatisticamente significativa para T. canis e C. ohioensis nos cães com até seis meses de idade quando comparados a animais acima de seis meses (P<0,0001). Quanto a variável sexo houve associação apenas com o ascarídeo T. canis com maior ocorrência nos machos quando comparado as fêmeas (P = 0,0243). A associação da presença das formas evolutivas dos parasitos com raça dos cães não foi estatisticamente significativa. / Abstract: The enteroparasitoses generally affect the organic equilibrium of pets, being particularly worrying referring to dogs, due to intimate contact with the human being. The techniques coproparasitologics usually used in laboratorial routines for detection of gastroenteric parasitoses are indispensable for the diagnosis and consequence to determine the necessary of infected animals treatment. In this study we evaluated the occurrence of helminthoses and protozooses in dogs and its association with age, sex and race, as well as the efficiency of Willis-Mollay, Faust, Sedimentation and exam Direct methods. It was processed 401 fecal samples, being accomplished in 300 parts, the technique of Kinyoun for directed research of Cryptosporidium spp. The parasite found were Ancylostoma spp. (53.1%), Toxocara canis (20.7%), Cystoisospora ohioensis (15.7%), Trichuris vulpis (3.7%), Dipylidium caninum (2.5%), Cryptosporidium spp. (1.33%) and Taenia spp. (1.0%). There was a statistically significant difference for T. canis and C. ohioensis in dogs up to six months old (P<0,0001). The occurrence of T. canis was statistically bigger in males when compared to females (P=0,0243). The association of parasites with race was not statistically significant. Of the four dogs (1.33%) positives for Cryptosporidium spp., only one presented a semi liquid consistence faeces and light dehydration (5 to 7%), having this animal age superior to six months old, with simultaneous infection for Ancylostoma spp. The Willis-Mollay was more efficient in the diagnosis of Ancylostoma spp. and T. canis eggs. The Direct method was least efficient. The techniques were statistically the same as the occurrence of the C. ohioensis oocysts. / Orientador: Silvia Helena Venturoli Perri / Coorientador: Kátia Denise Saraiva Bresciani / Banca: Alessandro Francisco Talamini do Amarante / Banca: Solange Maria Gennari / Mestre

Orientador: Renato Herman Sundfeld / Coorientador: Lucas Silveira Machado / Banca: Ticiane Cestari Fagundes Tozzi / Banca: Leandro Azambuja Reichert / Resumo: Este estudo prospectivo, randomizado e paralelo analisou a alteração de cor, sensibilidade dental, grau de cooperação e satisfação de voluntários quando submetidos ao clareamento dental com peróxido de carbamida a 10%, empregado durante 21 dias por 2, 4 e 8 horas/dia. O tempo preciso do uso diário das moldeiras/produto clareador foi mensurado por meio de um microssensor TheraMon (Sales Agency Gschladt, Hargelsberhg, Áustria). Sessenta e seis voluntários, de ambos os gêneros, com idades entre 18 e 22 anos foram selecionados e distribuídos aleatoriamente em três grupos de estudo (n = 22), os quais receberam as informações sobre a presença do microssensor em suas moldeiras. O fator estudado foi o tempo de uso das moldeiras em três níveis: 2 (GI), 4 (GII) e 8 (GIII) hrs/dia. Para a análise clínica, as variáveis de resposta foram: grau de cooperação diária dos voluntários de acordo com o tempo de uso diário das moldeiras; grau de satisfação dos voluntários com o clareamento dental; eficácia do clareamento dental nos incisivos e caninos superiores e inferiores pelo método visual (Vita Classical) e digital (Vita Easyshade), assim como o grau de sensibilidade dental que foi avaliado com método analógico-visual. Os voluntários foram avaliados no período inicial (baseline), aos 7, 14 e 21 dias após o início do tratamento clareador e 14 dias após apenas para as observações da cor, sensibilidade e grau de satisfação. Os dados foram analisados com aplicação do teste ANOVA e pelo post test... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This prospective, randomized, parallel study analyzed the color change, tooth sensitivity, degrees of cooperation, and satisfaction of volunteers when submitted to at home dental bleaching with 10% carbamide peroxide (Opalescence -Ultradent Products, Inc. South Jordan, USA) for 21 consecutive days for 2, 4 and 8 hours/day. The wear time of acetate trays/dental bleaching was measured through a TheraMon microsensor (TheraMon® microelectronic system; Sales AgencyGschladt, Hargelsberhg, Austria). Sixty six volunteers, both sexes, with ages ranging from 18 to 22 years were selected and randonly distributed into 3 study groups (n=22). The volunters received information about presence of the microsensor in their trays. The fator studied was the wear time of the trays in three levels: during 2 (GI), 4 (GII) and 8 (GIII) hours/day. For the clinical analysis the response variables were: the degree of daily cooperation of the volunteers as the wear time/daily of the trays, microelectrically collected by micro sensor TheraMon®; the degree of satisfaction of volunteers with dental bleaching; the effectiveness of dental bleaching in the upper and lower incisors and canines teeth, by the visual method (Vita Classical) and digital (Vita Easyshade) and dental sensitivity was evaluated by the volunteers with a scale visual analog method on a scale of 0 to 10. The volunteers were evaluated at baseline period, at one, two and three weeks after the beginning of the bleaching treatment, and again ... (Complete abstract click electronic access below) / Mestre

Darbo tikslas. Įvertinti klinikinės diagnostikos laboratorijos klaidas ir jų valdymo galimybes. Tyrimo metodika. Atlikta X ligoninės klinikinės diagnostikos laboratorijos klaidų registro 2007 – 2009 metų duomenų analizė ir susisteminti duomenys. Jais remiantis, identifikuotos klaidos, jų priežastys ir pasiskirstymas. Atlikta ligoninės skyrių, tiesiogiai susijusių su laboratoriniais tyrimais, darbuotojų (gydytojų ir slaugytojų) anketinė apklausa. Išdalinta 260, grąžinta 241 anketų (atsakas 92,7 proc.). Požymių ryšio reikšmingumui skaičiuotas χ2 kriterijus, dviejų proporcijų lyginimui - z kriterijus. Rezultatai. Iš visų klaidų (N=669) didžiausia dalis (80 proc.) identifikuota ikianaliziniame tarpsnyje. Dažniausios ikianalizinio tarpsnio klaidos - tyrimo užsakymo (22 proc.), ėminių ėmimo (23 proc.), užsakymo formos pildymo (21 proc.), įvykusios hemolizės (11 proc.). Kituose tarpsniuose klaidų pasiskirstymo dažnis ženkliai mažesnis: analiziniame. ir poanaliziniame po 10 proc. Analiziniame tarpsnyje didžiausią dalį užima klaidos, identifikuotos matavimo metu dėl ikianalizinių veiksnių poveikio (31 proc.), poanaliziniame - žmogiškojo faktoriaus ir elektroninių programų nesusidirbimo klaidos (41 proc.). Nustatyta, kad darbuotojų informuotumas apie laboratorijos klaidas ir jų valdymą yra nepakankamas. 55,9 proc. darbuotojų mano, kad apie galimas klaidas, lemiančias laboratorinių tyrimų patikimumą, bei jų išvengimo galimybes, žino tik iš dalies. Informacijos apie laboratorinio tyrimo... [toliau žr. visą tekstą] / Aim of the study: Evaluate clinical diagnostics laboratory errors and their management possibilities. Study methodology: Laboratory X error registry study performed (2007 – 2009 year). Survey among hospital staff related to laboratory test ordering conducted. Total responses: 241 (92.7% from 260 invitations). Criterions calculated: indication relation significance - χ2, couple proportions comparison - z. Results: Error distribution (total 669) by phase: 80% pre-analytical, 10% analytical, 10% post-analytical. Top errors in pre-analytical phase: specimen collection (23%), test ordering (22%), order form input (21%), hemolyzed sample (11%). Analytical phase most errors are influenced by pre-analytical variables (31%). Post-analytical phase most errors are caused by human factor and software malfunction (41%). Found, that hospital staff awareness about laboratory errors and their handling is insufficient. 55.9% staff responded they have only partial knowledge about errors influencing testing reliability and how to avoid errors. 51.3% staff has knowledge about test process organization. 33.3% staff knows about error classification by phase. 71.4% doctors and 42.6% nurses consider such information important and would like to learn more. 52% doctors and 33.8% nurses familiar with full set of available tests. More knowledge about available laboratory tests have staff of age >54y (58.1%), also, having employment history >24y (48.6%). Most of staff (expectation of 81.9% respondents... [to full text]

Primary aldosteronism (PA) is a common form of secondary hypertension with an international prevalence rates between 5 and 10 %. It is characterized by a high autonomous aldosterone production that causes cardiovascular damage, renin suppression, hypertension, sodium retention, potassium excretion and hypokalemia. The screening of PA is a simple test measuring aldosterone to renin ratio (ARR) with immunoassay method. This test is currently considered as the most reliable screening tool for PA.     The main objective of the study was to evaluate an ELISA-method, for detection of aldosterone and renin in blood plasma, to be used for routine analysis in the laboratory. The second aim was to investigate the effect of refreezing samples, considering that cryoactivation of prorenin might occur.     One hundred blood samples were analysed, in regard to aldosterone and renin, by using two commercial ELISA assays (DRG ELISA from DRG Diagnostics, Germany) on a Dynex DS2 instrument. In addition, the accuracy and precision of the methods were calculated. The effect of refreezing was investigated with a series of eight samples, which were analyzed twice on the same instrument.     Both assays performed well. The resulting data showed good precision and accuracy. The correlation between the original and refreezed samples was good, r = 0.989 and r = 1.0 for aldosterone and renin respectively. Considering that the study only included eight samples, further investigation is recommended.     Evaluation showed that both immunoassays are reliable in diagnostic use and the ELISA-method is suitable to implement in the laboratory for routine analysis.

Avsaknad av en ”gyllene standard” och en låg sensitivitet hos förstahandsmarkören total B12 har varit de stora begränsningarna i diagnostiken av vitamin B12-brist anemier. Med syftet att förbättra diagnostiken av bristanemier vid Länssjukhuset Ryhov, Jönköping utvärderades användningen av aktivt B12 vid bristanemiutredningar och en metodverifiering för analysen genomfördes på ARCHITECT i2000SR. Sambandet mellan aktivt B12 och totalt B12 undersöktes med en korrelationsanalys för totalt B12-nivåer: låg (n=10, &lt;148 pmol/L), gråzonen (n=10, 149–200 pmol/L) och normal (n=10, 201-250 pmol/L). För bestämning av träffsäkerheten hos aktivt B12 studerades 14 bristanemifall. Ett receiver operating characteristic (ROC) diagram skapades och arean under kurvan (AUC) beräknades. Variationskoefficient (CV) för mellanliggande- och inomserieprecision för aktivt B12 var 4,4 % respektive 2,4 %. Svag korrelation observerades i alla B12-nivåer, men sammantaget resulterade nivåerna i en medelstark korrelation (R=0,600). Aktivt B12 med ett gränsvärde på 40 pmol/L resulterade i en hög specificitet (75 %) och sensitivitet (80 %) med en AUC på 90 %. Analys av aktivt B12 på ARCHITECT i2000SR möjliggör en precis mättning av aktivt B12 i humant serum och därför är lämplig för rutinmässig användning. Träffsäkerheten hos aktivt B12 var hög och markören kan därmed rekommenderas för användning vid bristanemiutredningar vid Länssjukhuset Ryhov, Jönköping. / Diagnosis of vitamin B12-defiency anemia has been challenging due to lack of ”gold standard” and poor sensitivity of total B12 as a first line marker. With the aim of improving diagnostic of anemia investigations at county hospital Ryhov, Jönköping, we performed a method verification for active B12 on ARCHITECT i2000SR and evaluated the usefulness of active B12 in diagnosing anemia. Correlation analysis was performed using samples with different total B12 ranges: low (n=10, &lt;148 pmol/L), grey zone (n=10, 149-200 pmol/L) and normal (n=10, 201-250 pmol/L). Receiver operating characteristic (ROC) curve was created and area under the curve (AUC) was calculated for determining accuracy of active B12 using 14 deficiency cases. Coefficient of variation (CV) for within-run and total imprecision, for active B12 was 2,4 % and 4,4 %, respectively. Weak correlation was found between B12-ranges, however a moderate correlation (R=0,600) was found including all groups. Active B12 with the cut-off value of 40 pmol/L resulted in high specificity (75%) and sensitivity (80%) and had an AUC of 90 %. Active B12 assay on ARCHITECT i2000SR allows a precise measurement of active B12 in human serum and therefore is adequate for routine use. Active B12 had high accuracy and can be recommended in anemia investigations in county hospital Ryhov, Jönköping.

Made available in DSpace on 2014-06-11T19:27:18Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-04-24Bitstream added on 2014-06-13T20:16:25Z : No. of bitstreams: 1 taparo_cv_me_araca.pdf: 677501 bytes, checksum: cb871034a8580ee800d34d6d183f9ac3 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / As enteroparasitoses comumente afetam o equilíbrio orgânico dos animais de estimação, sendo isto particularmente preocupante em relação aos cães, devido ao intimo contato destes com o homem. As técnicas coproparasitológicas usualmente utilizadas na rotina laboratorial para detecção de parasitoses gastrintestinais são indispensáveis para o diagnóstico e por conseqüência para determinar a necessidade de tratamento dos animais infectados. Neste estudo objetivou-se avaliar a ocorrência de helmintoses e protozooses em cães domiciliados e sua associação com faixa etária, sexo e raça, bem como a eficiência dos Métodos Willis- Mollay, Faust, Sedimentação e Exame Direto quanto a recuperação de ovos e oocistos de parasitos gastrintestinais da espécie canina. Foram processadas 401 amostras fecais, sendo que em 300 foi efetuada a Técnica de Kinyoun para pesquisa de Cryptosporidium spp. Os parasitos encontrados foram Ancylostoma spp. em 53,1%, Toxocara canis em 20,7%, Cystoisospora ohioensis em 15,7%, Trichuris vulpis em 3,7%, Dipylidium caninum em 2,5%, Cryptosporidium spp. em 1,33% e Taenia spp. em 1,0% das amostras. A positividade para Ancylostoma spp. não foi influenciada pelas variáveis raça, sexo e idade. Houve diferença estatisticamente significativa para T. canis e C. ohioensis nos cães com até seis meses de idade quando comparados a animais acima de seis meses (P<0,0001). Quanto a variável sexo houve associação apenas com o ascarídeo T. canis com maior ocorrência nos machos quando comparado as fêmeas (P = 0,0243). A associação da presença das formas evolutivas dos parasitos com raça dos cães não foi estatisticamente significativa. / The enteroparasitoses generally affect the organic equilibrium of pets, being particularly worrying referring to dogs, due to intimate contact with the human being. The techniques coproparasitologics usually used in laboratorial routines for detection of gastroenteric parasitoses are indispensable for the diagnosis and consequence to determine the necessary of infected animals treatment. In this study we evaluated the occurrence of helminthoses and protozooses in dogs and its association with age, sex and race, as well as the efficiency of Willis-Mollay, Faust, Sedimentation and exam Direct methods. It was processed 401 fecal samples, being accomplished in 300 parts, the technique of Kinyoun for directed research of Cryptosporidium spp. The parasite found were Ancylostoma spp. (53.1%), Toxocara canis (20.7%), Cystoisospora ohioensis (15.7%), Trichuris vulpis (3.7%), Dipylidium caninum (2.5%), Cryptosporidium spp. (1.33%) and Taenia spp. (1.0%). There was a statistically significant difference for T. canis and C. ohioensis in dogs up to six months old (P<0,0001). The occurrence of T. canis was statistically bigger in males when compared to females (P=0,0243). The association of parasites with race was not statistically significant. Of the four dogs (1.33%) positives for Cryptosporidium spp., only one presented a semi liquid consistence faeces and light dehydration (5 to 7%), having this animal age superior to six months old, with simultaneous infection for Ancylostoma spp. The Willis-Mollay was more efficient in the diagnosis of Ancylostoma spp. and T. canis eggs. The Direct method was least efficient. The techniques were statistically the same as the occurrence of the C. ohioensis oocysts.

Made available in DSpace on 2014-06-11T19:23:04Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-08-19Bitstream added on 2014-06-13T20:49:56Z : No. of bitstreams: 1 nunes_tn_me_arafcf.pdf: 1863822 bytes, checksum: 9b5c6611ece4cf06ddf8012fddc415ef (MD5) / Universidade Estadual Paulista (UNESP) / O uso de amostras-controle para acompanhamento do desempenho analítico é necessário para reproduzir a veracidade dos resultados das análises, pois monitora as variações que podem ocorrer no sistema analítico. O ideal para amostras-controle é ter a mesma matriz que as amostras dos pacientes, assim elas comportar-se-ão da mesma forma. Entretanto, para alcançar a estabilidade necessária, as amostras-controle passam por manipulações durante sua produção que podem alterar as propriedades da matriz. Dentre estas manipulações estão a adição de aditivos e mudanças físicas do meio como o congelamento ou liofilização. Neste estudo, nós produzimos amostras-controle com pool de soro humano trabalhados na forma líquida, congelados, conservados a ≤ -18°C e ≤ -80°C e sólida a 2 - 8°C liofilizados, sem preservante e com preservante e analisamos 23 analitos da rotina de laboratório clínico: ácido úrico, albumina, fosfatase alcalina, alanina aminotransferase, amilase, aspartato aminotransferase, bilirrubina direta, bilirrubina total, cálcio, capacidade latente de ligação do ferro, colesterol, creatinina, ferro, fósforo, gama-glutamil transferase, glicose, colesterol- HDL, desidrogenase lática, potássio, proteínas totais, sódio, triglicérides e uréia. As amostras foram analisadas por 300 dias, e comparado a estabilidade entre os soros sem preservante e com preservante nos diferentes processos de conservação. Os coeficientes de variação encontrados foram bastante satisfatórios, mas a estabilidade no decorrer do tempo foi melhor observada no soro com preservante, especialmente a 2 - 8°C - liofilizado, onde todos os analitos estudados permaneceram estáveis por 300 dias, com exceção do ácido úrico que foi de 240 dias / Using control-samples for analytical performance monitoring is required to reproduce the veracity of the results of biochemical analyses, since them monitors changes that may occur in analytical system. The ideal for control-samples is to have the same matrix that samples of the patients, so they will behave the same way. However, to achieve the necessary stability control-samples undergo operations such as sum additives and/or physical changes of middle (freezing or lyophilization) during its production which can change the properties of the matrix. In this study, we produced control-samples with pool of human serum worked in frozen liquid form kept at ≤ -18°C and ≤ -80°C and freeze-dried solid kept between 2 – 8°C, without or with a preservative for 23 analytes of clinical laboratory routine: uric acid, serum albumin, alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, amylase, direct bilirubin, total bilirubin, calcium, latent iron-binding capacity, cholesterol, creatinine, iron, phosphorus, gamma glutamyl transferase, HDL-cholesterol, glucose, lactic dehydrogenase, total proteins, potassium, sodium, triglycerides and urea. The samples were analyzed for 300 days, and the stability compared between the without a preservative and with a preservative sera in different processes of conservation. The coefficient of variation found were quite satisfactory, but stability over time was better observed in with a preservative serum, mainly in serum stored between 2 – 8°C - freeze-dried, in which all analytes studied remained stable for 300 days, with the exception of uric acid that was for 240 days

Duktal bröstcancer är den vanligaste formen av invasiva brösttumörer. Graderingssystemet för bröstcancer har definierats av Elston och Ellis och är baserat på tre parametrar. En av dessa är räkning av antal mitoser på preparat färgade med Hematoxylin och Eosin (HE). Som ett komplement vid bedömning av bröstcancer analyseras Ki67, en proliferationsmarkör, med hjälp av immunhistokemi (IHC).  Fosfohiston H3 (pHH3) är ett histonprotein som finns i cellkärnan. Proteinet tros vara en specifik markör för mitos eftersom den är fosforylerad enbart under M-fasen och i slutet av G2-fasen. Syftet med studien var att utvärdera pHH3 som potentiell markör för mitos vid diagnostiseringen av duktal bröstcancer. Syftet var även att jämföra metoden med räkning av antal mitoser och Ki67-positiva celler, samt att studera den interindividuella skillnaden vid bedömningen av preparaten. Materialet bestod av 20 sektorresektat med invasiv duktal bröstcancer. Preparaten färgades med IHC och bedömdes mikroskopiskt. Celler som var positiva för pHH3 och Ki67 samt antal mitoser räknades, av tre läkare. Ett medelvärde för varje patientfall och metod beräknades från läkarnas bedömningar. Metodernas variationskoefficienter och dess medelvärden beräknades. Variationskoefficienterna uppvisade medelvärden på 0,21 för Ki67 +/- 0,10 SD, 0,33 för pHH3 +/- 0,14 SD och 0,46 för mitosräkning +/- 0,34 SD. Korrelationskoefficienterna för metoderna och respektive läkare uppvisade en spridning. Korrelationerna uppvisade medelvärden på r = 0,78 för Ki67 och pHH3, r = 0,74 för Ki67 och mitos samt r = 0,83 för pHH3 och mitos. Enligt studien verkar antipHH3 vara ett bra komplement vid bedömning av duktal bröstcancer. Dock krävs tydliga kriterier för vad som ska räknas som en pHH3-positiv cell. Intervariabiliteten verkar bli mindre med anti-pHH3 än vid räkning av mitoser, som är mer tidskrävande. Minst intervariabilitet ses vid bedömning av anti-Ki67 som en proliferationsmarkör. / Ductal carcinoma of the breast is the most common form of invasive breast tumours. The grading system for breast cancer is defined by Elston and Ellis and is based on three criterions. One of these criterions is the mitotic count in pathological sections of breast carcinomas stained with Hematoxylin Eosin. A common method often applied as a complement in diagnosis of breast carcinoma is immunohistochemical staining with use of antibodies directed against Ki67, a proliferation marker. Phosphohistone H3 is a histone protein that is located in the cell nucleus. The protein is believed to be a specific marker for mitosis since it only is phosphorylated during mitosis, and to some extent at the end of the G2-phase. The purpose of this study was to evaluate pHH3 as a potential marker for mitosis when diagnosing ductal breast cancer. The purpose was also to compare the method to mitotic figuring and the count of Ki67-positive cells, and to study the inter-individual variability when assessing the histological sections. The material consisted of 20 biopsies containing invasive ductal breast cancer. The sections were stained using IHC and all sections were evaluated microscopically. Cells positive for pHH3, Ki67 and mitotic cells were quantified, by three doctors. From the doctors results an average value was determined for each case and method. To be able to compare the methods the coefficient of variation was calculated. The average value of the coefficient of variation was determined for each method and also the standard deviation (SD). The coefficient of variation showed average values of 0,21 for Ki67 +/- 0,10 SD, 0,33 for pHH3 +/- 0,14 SD and 0,46 for mitotic figuring +/- 0,34 SD. The correlation coefficients for the methods and each doctor showed dispersion. The correlations showed average values of r = 0,78 for Ki67 and pHH3, r = 0,74 for Ki67 and mitosis and r = 0,83 for pHH3 and mitosis. According to this study it seems as though anti-pHH3 could complement the other methods. However explicit criteria which defines a threshold value of which cells should be considered pHH3-positive needs to be established. The inter-individual differences seem to decrease using antipHH3 compared with mitotic counting, which is more time consuming. Although the minimum difference can be seen when assessing anti-Ki67 as a proliferation marker.

Orientador: Celia Regina Garlipp / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-14T10:39:56Z (GMT). No. of bitstreams: 1 Cussiol_AndreaKanashiro_M.pdf: 1521906 bytes, checksum: c2f5955dab234799f92b9b12026868db (MD5) Previous issue date: 2009 / Resumo: O presente trabalho foi realizado no Laboratório do Hospital Unimed Sorocaba com o objetivo de avaliar a aplicabilidade e benefícios da Tecnologia da Informação (TI) no gerenciamento técnico e administrativo-financeiro, por meio de indicadores de desempenho (produção, produtividade e recoleta), qualidade (pesquisa de satisfação de pacientes e médicos) e econômicos (custos). Com a implantação do Sistema de Informação do Laboratorial (SIL), desenvolvido em 2000 pela instituição, em parceria com uma empresa segmento da TI, sucessivos processos laboratoriais foram aprimorados e/ou automatizados ao longo do tempo. Os dados utilizados compreenderam o período entre os anos de 1.996 e 2.008, sendo que os resultados de crescimento na produção foram de 589% e nas requisições de exames foram de 141%. Neste intervalo de tempo os recursos humanos progrediram em 112%, com maior necessidade de expansão no setor de coleta. O indicador de produtividade geral demonstrou um desenvolvimento significativo. A satisfação dos pacientes com o LUS teve um desempenho de 88% em 2007 e 82% no ano de 2008, onde esta tendência desfavorável justifica-se principalmente pela limitação de infra-estrutura nas áreas de atendimento ao paciente (recepção e coleta). O índice de satisfação do corpo clínico frente aos serviços laboratoriais foi de 98% e as sugestões dos clínicos foram revertidas em melhorias do serviço. Os custos foram analisados entre 2004 e 2008. Houve uma significativa variação nos custos totais do LUS, o que se deve ao aumento na produção, no custo dos insumos laboratoriais, manutenção das unidades de pagamento por exame realizado e conseqüente defasagem na relação despesa/receita. Em 2007/2008 houve um incremento de 17% na produção, com economia de 13,5% no custo total, sugerindo diluição dos custos fixos. Pode-se concluir que a TI contribuiu com o desenvolvimento do LUS e com o progresso da qualidade analítica e gerencial. Utilizando a análise crítica dos indicadores, constatou-se que o franco aumento da produção e produtividade não demandou proporcional adequação da infraestrutura. Finalmente constata-se que os esforços intelectuais e manuais da equipe, bem como a integração multidisciplinar, são imprescindíveis para o êxito da aplicação da TI no laboratório clínico. / Abstract: The present study was performed at the Laboratory of Unimed Hospital in Sorocaba (LUS) with the objective to evaluate the applicability and benefits of the Information Technology (IT), in technical and financial-administrative management, through indicators of performance (production, productivity and recollection), quality (satisfaction research of patients and medical) and economical (costs). With the introduction of the Laboratory Information System (LIS), developed in 2000 in the institution successive laboratory processes were improved and / or automated along the time. The used data understood the period between the years of 1.996 and 2.008, being that the results were of: growth of 589 % in the production and of 141 % in the tests requests. In the same period, human resources increased in 112%, with more need of expansion in the collection sector. The indicators of general productivity demonstrated a significant growth. The patient satisfaction with LUS had a performance of 88% in 2007 and 82% in 2008, where this unfavorable trend can be justified by the limited infrastructure in the areas when the care of the patient happens (reception and collection sectors). The satisfaction rate of the clinical staff that concerns laboratory services was 98% and the clinical suggestions were reversed in services improvement. The costs where analyzed between 2004 and 2008, being the laboratory responsible for 10% of the overall cost of the institution. There was a significant variation in the total costs of LUS which is due to the production growth, the cost of laboratory inputs, maintenance of the payments units for tests performed and a consequent discrepancy between expenditure and income. In the 2007/2008 period there was an increased of 17% in the production, with a significant economy of 13,5%, that suggests dilution of fixed costs. We can conclude that IT contributed with the development of LUS and the progress of analytical and management quality. We can conclude that IT contributed with the development of LUS and the progress of analytical and management quality. Through a critical analysis of the indicators has been found that the significant increase of production and productivity did not require proportional adequacy of the infrastructure. Finally it is noticed that the intellectual and manual efforts of the team, as well as the multidisciplinal integration, are essential for the result of the application of IT in the clinical laboratory. / Mestrado / Ciencias Biomedicas / Mestre em Ciências Médicas